Priority Area 4: Healthy Relationships

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Priority Area 4: Healthy Relationships

Table of Contents

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Table of Contents Table of Contents................................................................................................................................... 2 Introduction.............................................................................................................................................. 3 History........................................................................................................................................................ 3 Youth Development Vocabulary .................................................................................................. 4 Data ............................................................................................................................................................. 4 Goals ........................................................................................................................................................... 6 Objectives ................................................................................................................................................. 6 Strategies.................................................................................................................................................. 6 Evaluation ................................................................................................................................................. 7 Collective Impact Concepts............................................................................................................... 8 Appendix A ............................................................................................................................................... 9 Bibliography ........................................................................................................................................... 11

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Introduction Health outcomes for children and youth are influenced by social environments and frequently are mediated by behaviors. Youth who are connected to high quality out of school programs and have adult mentors are more likely to grow-up healthy than disconnected youth. Actions and activities of young people are influenced at the individual, peer, family, school, community, and societal levels (Healthy People 2020). This means that kids are influenced not simply by what they know, but also who they know, what they feel, where they spend time, and how they are treated. Well-designed youth activities increase the developmental assets and protective factors needed for children and youth to lead healthy and productive lives. In other words, kids who are involved in high-quality, out of school programs increase their chances for living healthier lives than kids who are disconnected from these programs. Intuitively one knows that kids who participate in clubs, sports, or other extracurricular activities outside of school are starting life with an advantage over kids who are not involved and disconnected from positive activities. Science provides evidence that this intuition is correct. As a regional health leader, the Foundation will work to help kids grow-up healthy by decreasing the prevalence of disconnection through increased density of youth programs and recruitment of more disconnected youth into high-quality programming. The IGNITE Initiative is aligned with the Foundation’s mission to promote health and prevent disease through leadership in health education, research, and advocacy. The purpose of this initiative is to simply get disconnected youth to become involved with at least one high-quality out of school program so as to increase their chances of growing-up healthy.

History In 2010, the Foundation convened multiple stakeholders in Ciudad Cuidad Juárez to discuss opportunities for youth and to lead community based organizations to bring health promotion and disease prevention to the residents of Cuidad Juárez. These meetings confirmed the concerns of Foundation Board and Staff: children and youth were living in environments that put them at risk for use of alcohol, tobacco, and drugs. Youth were also at an increased risk of exposure to and participation in violence and criminal activity. The problem wasn’t that kids didn’t know that drugs were unhealthy or that violence was illegal. Limited school enrollment, lack of safe places for play and recreation, and chronic unemployment were major contributors to these behaviors. In 2011, the Foundation funded five organizations with the goal of providing safe places for youth to participate in healthful activities across Cuidad Juárez. Evaluation results showed that Foundation funded programs allowed more kids to be in more safe places. Research confirms that such impact contributes to long-term positive outcomes among youth. On July 19 2012, the PdNHF Board of Directors approved the strategic plan for the Positive Youth Development Initiative. In the same meeting, the reclassification of three HEAL proposals to Priority Area 4-Healthy Relationships was also approved. Under this new initiative, three organizations were funded for the purpose of providing activities to children and youth in a positive and safe environment. IGNITE-3

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On May 16, 2013, the PdNHF Board of Directors approved the 2013-2016 IGNITE strategic plan, which provided more organized and focused efforts for promoting health amongst disconnected youth through out of school programming. In July of the same year, seven organizations-three from Cuidad Juárez and four from Texas-were funded to advance the goals of the Initiative. This document is an update to the approved strategic plan, based on learnings and new data obtained in year one.

Youth Development Vocabulary “Positive youth development” is an intentional approach that engages youth within their communities, schools, organizations, peer groups, and families in a manner that is productive and constructive. It recognizes, utilizes, and enhances youths' strengths. It also promotes positive outcomes for young people by providing opportunities, fostering positive relationships, and furnishing the support needed to build on their leadership strengths (Find Youth, 2013). In contrast, unintentional approaches might include activities like after school day care or programs without clearly defined outcomes. The Foundation refers to “disconnected youth” as people between the ages of 7 – 18 years old who are not involved in out of school activities or participating in the labor market (PdNHF definition, 2013). “Out of School Programs” are sets of activities that are implemented outside regular school hours, on weekends, or during holiday breaks, and incorporate best practices of Positive Developmental Settings for out of school programs as shown in Table 1-Appendix A.

Data There are more than five hundred thousand children and youth (K-12) in the region. County Child Population El Paso 240,813 Hudspeth 1,047 Doña Ana 64,513 Luna 7,380 Otero 17,799 Cuidad Juárez 304,730 TOTAL 636,282 (Kids Count, 2010; INEGI, 2010) The CDC estimates that 18% of youth ages 12-17 do not participate in any out of school activity. Regionally, 23% of youth ages 7-18 are disconnected. The following are gross numbers of disconnected youth in the PdNHF region:

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Population Disconnection at 23% County Youth Disconnection El Paso 55,387 Hudspeth 241 Doña Ana 14,838 Luna 1,697 Otero 4,094 Cuidad Juárez 70,088 TOTAL 146,345 A meta analysis of 68 afterschool studies concluded that high quality afterschool programs can lead to improved attendance, behavior and coursework. Students participating in a high quality afterschool program went to school more, behaved better, received better grades and did better on tests compared to non-participating students. (Durlak, Weissberg, & Pachan, 2010) A study measuring the health and social benefits of afterschool programs found that controlling for baseline obesity, poverty status, and race and ethnicity, the prevalence of obesity was significantly lower for afterschool program participants (21 percent) compared to nonparticipants (33 percent). (Mahoney, J., Lord, H., & Carryl, E., Lawrence Erlbaum Associates, Inc, 2005) Teens who do not participate in afterschool programs are nearly three times more likely to skip classes than teens who do participate. They are also three times more likely to use marijuana or other drugs, and are more likely to drink, smoke, and engage in sexual activity. (YMCA of the USA, 2001) The hours between 3 and 6 p.m. are the peak hours for juvenile crime and experimentation with drugs, alcohol, cigarettes, and sex (Fight Crime: Invest in Kids, 2003). During the summer months, first time use of alcohol, tobacco, and drugs peaks among kids 12 to 17 years old (SAMHSA, 2012). “A decade of research and evaluation studies, as well as large-scale, rigorously conducted syntheses looking across many research and evaluation studies, confirms that children and youth who participate in afterschool programs can reap a host of positive benefits in a number of interrelated outcome areas—academic, social/emotional, prevention, and health and wellness” (Harvard Family, 2008). Addressing the positive development of young people facilitates their adoption of healthy behaviors and helps to ensure a healthy and productive future population (McNeely, 2009). An initial strategy of the initiative was to produce a density map of youth programs overlaid with youth population. Maps were produced in March 2014 for all five U.S. counties in the Foundation’s service region and the municipality of Cuidad Juárez. The research indicates the following geographic areas have low densities of youth programs and a high proportion of youth:

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New Mexico Mexico Doña Ana County Cuidad Juárez Luna County Otero County

Texas Anthony Canutillo Clint Fabens Horizon City Montana Vista San Elizario Sparks Socorro

The intent is to focus program expansion in these areas in order to serve more disconnected youth. IGNITE maps were updated in 2016 and can be accessed on the Foundation’s web site. Goals  

To improve a range of health outcomes by engaging disconnected youth in the Paso del Norte Region in high-quality programs during out of school hours. To provide the Foundation and Community with an opportunity to learn more about disconnected youth.

Objectives     

Decrease the prevalence rate of disconnection by 5% (approximately 31,000 youth) by 2025. Establish at least ten programs in target areas for disconnected youth by July 31, 2018. All partner program sites have at least five of the seven quality assessment indicators by July, 2018. Identify characteristics that are common among disconnected and connected youth and identify effective approaches for recruiting disconnected youth by July, 2018. All partner organizations will have at least two evidence based strategies in place to promote healthy eating and active living among youth by July, 2018.

Strategies    

Create and deploy a Quality Youth Program assessment to determine change in program quality. Offer technical assistance based on identified needs. Conduct an analysis of government agency policies that contribute to disconnection. Coordinate with the backbone organization to lead technical assistance to grantees, communication campaigns, and coalition efforts. Establish a regional coalition to increase coordination and communication among regional agencies/coalitions and increase opportunities for disconnected youth. IGNITE-6

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   

Offer technical assistance and training to partner and community organizations for enhancing recruitment strategies, improving program quality, and positive youth development approaches. Recommend evidence based models for organizations requesting assistance. Conduct an open RFP and issue grants to help organizations expand their current youth programs to recruit and serve more disconnected youth in identified target communities. Leverage other funding sources when possible. Evaluate Foundation and Grantee efforts in relation to disconnected youth.

Evaluation The initiative’s objectives are listed followed by the evaluation approach for each: 

Objective #1: Decrease the prevalence rate of disconnection by 5% (approximately 31,000 youth) by 2025.

HRiA will measure the prevalence of disconnection in the region through random digit dial survey will be used in the US and Ciudad Juárez. The Foundation will also measure this by the number of youth served through grantee programs. 

Objective #2: Establish at least ten programs in target areas for disconnected youth by July 31, 2018.

This will be evaluated by a simple count of new programs in the target geographic areas established by IGNITE. 

Objective #3: All partner organizations have at least five of the seven quality assessment indicators by July 31, 2018.

An independent evaluator will design the data collection tool and process. The evaluation team will train grantees on data collection procedures. Final analysis and reporting will be completed by the evaluators. The evaluation measure of success if that all IGNITE grantees have at least five of the seven quality indicators in place as judged by the independent evaluator by July 31, 2018. 

Objective #4: Identify characteristics that are common among disconnected and connected youth and identify effective approaches for recruiting disconnected youth by July 31, 2018.

The independent evaluator will use a variety of techniques to identify and describe common characteristics of disconnected and connected youth within the PdN service region. It is anticipated that the evaluators will use thematic analysis to analyze qualitative data collected during interviews with program staff and youth clients. These profiles will be valuable as the Foundation and partner organizations consider the best approach to recruit, retain, and serve disconnected youth. The deliverable is a report that elucidates the identified characteristics and effective approaches. Based on this report, IGNITE will be in a position to be even more effective. IGNITE-7

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Objective #4: All partner organizations will have at least two evidence based strategies in place to promote healthy eating and active living among youth by July 31, 2018.

In collaboration with an independent external consultant, a data collection system will be designed to review the two evidence based strategies each partner organization will utilize. Effective outcomes will contribute to the Foundation’s vision of becoming a top U.S. region for healthy eating and active living.

Collective Impact Concepts The initiative will be executed and evaluated with fidelity to the following five concepts of Collective Impact. Emerging literature suggests that Collective Impact approaches increase likelihood of social change (Kania & Kramer, 2011; Hanleybrown, Kania, & Kramer, 2012). Below is a description of the five concepts: 1) Common Agenda: All initiative partners, funded and non-funded, have a shared vision for change including a common understanding of the problem and a joint approach to solving it though agreed upon actions. All grantees currently share the vision of increasing the number of connected youth in the Paso del Norte region. A Coalition will be established to garner the support of non-funded partners and other community members in the region to advance the goals of the IGNITE initiative. 2) Shared Measurement: Shared measures help ensure efforts remain aligned and participants hold each other accountable. Other evaluation data, both quantitative and qualitative, are specific to individual organizations/programs and used to document progress and improve programs. The Initiative’s evaluators have established shared measures for collecting data from grantees and the community to improve programs and advance the Initiative’s goals. There is a common set of definitions as well as shared indicators for quality programs. 3) Mutually Reinforcing Activities: Partner activities must be differentiated while still being coordinated through a mutually reinforcing plan of action. Some partners typically work toward individual or family level change while others work on larger scale organizational and public policy change. It is the synergy of these multiple mutually reinforcing activities by multiple partners that creates change. Once the Coalition is established, partner organizations and community members will work together to identify and explore policies or other opportunities that can strengthen existing activities under the Initiative. 4) Continuous Communication: Consistent and open communication is needed across the many partners to build trust, assure mutual objectives, and create common motivation. A coalition is frequently a central mechanism for communication. The Backbone Organization and Coalition will work to effectively communicate the goals, common agenda, and shared measures of the IGNITE initiative in ways that engage and motivate community members and other potential partners. Likely there will be monthly meetings that will provide a space for all partners to share knowledge and skills. 5) Backbone Organization: Creating and managing collective impact requires a separate organization with staff and a specific set of skills to serve as a backbone for the entire initiative, to coordinate partner organizations, and to manage the first four elements of Collective Impact. IGNITE-8

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An organizing agency was established in August 2014 to lead the initiative’s goals and serve as a liaison between the Foundation and partner organizations.

Appendix A TABLE 1: Features of Positive Developmental Settings (Eccles and Gootman, 2002). Indicators

Appropriate Structure

Community Involvement

Opportunities for Skill Building

Physical and Psychological Safety

Positive Social Norms

Supportive Relationships

Youth Involvement

Descriptors Limit setting, clear and consistent rules and expectations, firm-enough control, continuity and predictability, clear boundaries, and ageappropriate monitoring Concordance, coordination, and synergy among family, school, and community Opportunities to learn physical, intellectual, psychological, emotional, and social skills; exposure to intentional learning experiences; opportunities to learn cultural literacies, media literacy, communication skills, and good habits of mind; preparation for adult employment; and opportunities to develop social and cultural capital Safe and health-promoting facilities and practices that increase safe peer group interaction and decrease unsafe or confrontational peer interactions. Rules of behavior, expectations, injunctions, ways of doing things, values and morals, and obligations for service Warmth, closeness, connectedness, good communication, caring, support, guidance, secure attachment, and responsiveness Youth-based, empowerment practices that support autonomy, making a real difference in one’s community, and being taken seriously; practices that include enabling, responsibility granting, and meaningful challenge; and practices that focus on improvement rather than on relative current performance levels

Opposite Roles Chaotic, disorganized, laissez-faire, rigid, over controlled, and autocratic.

Discordance, lacking of communication, and conflict.

Practices that promote bad physical habits and habits of mind and practices that undermine school and learning.

Physical and health dangers, fear, feeling of insecurity, sexual and physical harassment, and verbal abuse. Normlessness, anomie, laissez-faire practices, antisocial and amoral norms, norms that encourage violence, reckless behavior, consumerism, poor health practices, conformity. Cold, distant, over controlling, ambiguous support, untrustworthy, focused on winning, inattentive, unresponsive, and rejecting.

Unchallenging, over controlling, disempowering, and disabling; and practices that undermine motivation and desire to learn, such as excessive focus on current relative performance level rather than improvement.

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Bibliography Afterschool Alliance.(2010). America after 3pm report on afterschool. Accessed on January 6, 2013 at: http://www.afterschooalliance.org/policyStateMap.cfm Afterschool Alliance. (2013). Afterschool Programs: Making a Difference in America's Communities by Improving Academic Achievement, Keeping Kids Safe and Helping Working Families. Accessed on April 2, 2014 at: http://www.afterschoolalliance.org/Afterschool_Outcomes_2013.pdf Annie E. Casey Foundation. (2010). Kids Count. Accessed December 21, 2013 at: http://datacenter.kidscount.org Eccles, Jacquelynne and Jennifer Appleton Gootman, Eds..Community Programs to Promote Youth Development. Board on Children, Youth, and Families. Committee on community-level programs for youth. 2002. Available at: http://www.nap.edu/openbook.php?record_id=10022&page=R1 Healthy People 2020 website. Accessed February 14, 2013 at: http://www.healthypeople.gov/2020/topicsobjectives2020/overview McNeely C, Blanchard J. The teen years explained: A guide to healthy adolescent development. Baltimore: Johns Hopkins Bloomberg School of Public Health, Center for Adolescent Health; 2009. Available from: http://www.jhsph.edu/adolescenthealth Resnick MD, Bearman PS, Blum RW, et al. Protecting adolescents from harm: Findings from the National Longitudinal Study on Adolescent Health. JAMA. 1997;278(10):823-32. Available from: http://jama.ama-assn.org/cgi/reprint/278/10/823

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